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Cauterization of cervical erosion: basic methods
Last reviewed: 23.04.2024
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As a radical method of treatment of pathological changes in the mucosa, cauterization of cervical erosion is carried out, during which destruction of the affected tissues occurs with their necrosis, rejection and subsequent regeneration of the healthy cells of the mucosal epithelium on the affected site.
[Indications and preparation for cauterization of cervical erosion
Indications for cauterization of cervical erosion - diagnosed ectopia, leukoplakia or erythroplasty of the cervical mucosa (with or without secretions). No special training is usually conducted. However, if a pathogenic bacterial, viral or fungal microflora is found in the vagina, the doctor prescribes medications to treat the corresponding infectious disease. Cauterization of erosion - the most appropriate method - is performed to achieve a positive result of antibacterial, antiviral or antifungal therapy.
According to the recommendations of specialists, this procedure is performed during the first phase of the patient's menstrual cycle - on the 7th-9th day, which provides faster healing and recovery of the mucosa and reduces the risk of cervical endometriosis.
The necessary tests before cauterization of cervical erosion include a smear on the microflora of the vagina and its PCR analysis for STDs (sexually transmitted diseases); general blood analysis; blood test for RV, HIV and hepatitis; biopsy and histological examination of tissue at the site of erosion.
Methods of cauterizing cervical erosion
In clinical gynecology today, the following methods of cauterization of cervical erosion are used:
- current (diathermocoagulation);
- nitrogen, or, as it is often called cryodestruction, freezing-the destruction of pathologically altered tissues by the action of ultralow temperatures;
- laser (laser vaporization);
- radio waves (radio wave coagulation);
- argon (argon-plasma ablation method);
- ultrasound;
- medication or chemical moxibustion.
The most traumatic method by the doctors themselves is diathermocoagulation: it is, in fact, a local contact thermal burn of the mucous membrane of the cervix with all the ensuing consequences. Moreover, the action of high frequency current also leads to spasms of the uterus muscles, and, in addition, in half the cases, erosion can occur repeatedly.
Methods of cryodestruction and laser vaporization are effective for small and shallow erosions. Freezing is carried out with liquid nitrogen (its temperature is about -196 ° C), the procedure practically does not cause pain and does not leave behind keloids. Also effective, painless and bloodless laser vaporization, in which erosion simply evaporates under the action of a precisely directed laser beam. The site of necrosis of the mucosa is covered with a coagulation film, which ensures the absence of bleeding and associated infection. The wound on the site of erosion quickly overgrows with a healthy tissue - without a single scar.
For radio wave coagulation, a modern electrosurgical low-frequency apparatus for cauterizing cervical erosion Surgitron (Surgitron) is used. This method is not highly traumatic, since the effect of the electric current converted into radio waves occurs in a non-contact way. Due to the absence of complications, in particular, the formation of scars that reduce the elasticity of the walls of the cervix, burning with Surgitron, most gynecologists consider the priority method of treatment of nulliparous women.
When radio wave treatment is also carried out cauterization Fotecom - cavitation ultrasound surgical apparatus of various modifications (most often this device Fotek E80M).
If Argon Plasma Coagulation is used, the procedure for removing pathological erosion tissues is performed by the Fotek-140-04 electrosurgical unit equipped with a special unit (EA142MV HF) or Argon plasma plasma coagulator. Ionized high-frequency argon through a special probe produces an effect on the erosion area with a clearly focused beam of plasma, without contact with tissues.
Cauterization Solkaginom - a method of contact chemical destruction. The preparation Solkagin in the form of a solution is a mixture of concentrated acids - nitric, oxalic, acetic and zinc nitrate hexahydrate. The application of this agent (using a tampon) to the place of erosion leads to necrosis of epithelial cells - due to the instantaneous clotting of their proteins. At the site of cauterization, a scab is formed, under which a layer of new epithelium forms over time.
To control the process of tissue regeneration, gynecological examinations are appointed - 10 days after the procedure, then two weeks later and 38-40 days after cauterization. The use of this drug causes burning and itching.
How long recovery after cauterization of cervical erosion occurs depends on the method used, and on the size of the affected area. On average, after cauterization, the mucosa regenerates after a couple of months, but can heal longer; after cryodestruction, laser cauterization or radio wave treatment - after about a month and a half. But the duration of the regeneration process can increase: individual characteristics of the patient's body, the state of their immunity, the presence of infections, etc., can be affected.
Cauterization of cervical erosion at home
Some doctors - with a small amount of pathology - recommend cauterization of cervical erosion at home with the antibacterial Polycrezulen (Vagotil), which acts not only as a powerful bacteriostatic, but also, due to the formaldehyde content, produces a local cauterizing effect by coagulating the protein of eroded tissues.
The method of application of this solution is to impose on the eroded zone of the vagina impregnated tampon - for 1-3 minutes, while the excess solution must be soaked with a dry sterile swab. The number of procedures for a week is two or three (as the doctor will say).
In a week, the dead tissue will begin to separate (discharge as with conventional chemical cautery), leaving no scar. Since Polycrezulen is an antiseptic, the regeneration of epithelial cells that have undergone necrosis occurs quickly and without inflammation. However, it is necessary to comply with the same restrictions, which implies any cauterization of cervical erosion.
Consequences after cauterization of cervical erosion
The most frequent short-term effects are pain, swelling of the vulva and discharge.
Localized in the lower abdomen, severe pain after cauterization of cervical erosion is especially often accompanied by diathermocoagulation. Given the double innervation of the cervix and vagina, the emergence of pain sensations of varying intensity should not disturb the patients: these pain quickly pass.
The natural process of rejection of destroyed tissues explains and the release after cauterization of cervical erosion. Minor vaginal discharge - a liquid consistency with an admixture of mucus will last up to 10 days after the procedure. There may also be bloody discharge, since if the mucous membrane is damaged for therapeutic purposes, the wound surface appears in any case and exudate is formed, which cleanses it of dead cells.
But a significant allocation of blood, especially characteristic again for diathermocoagulation, indicates the damage to one or more blood vessels of the cervix. In such situations Tranexam (other trade names - Trenaksa, Tranestat) - a haemostatic haemostatic drug (tablets of 250 mg) is prescribed: on a tablet up to 4 times a day.
Gynecologists do not rule out such a complication of any of the methods of destruction used, such as menstrual irregularity or delay.
When the secretions become yellowish or greenish-yellow, they are accompanied by putrefactive odor, and if even the overall temperature increases slightly, all this speaks for the development of inflammatory processes.
Most often, inflammation occurs due to the presence or attachment of urogenital infections. It is necessary to seek medical help without delay.
Also, doctors warn of the likely long-term negative consequences of cauterization of cervical erosion by diathermocoagulation associated with scar formation at the site of the departed scab. This constriction (stenosis) of the cervical canal, the accumulation of bloody exudates in it, the expansion of the blood vessels of the cervix or the appearance of bleeding foci on its walls (endometriosis). It is fraught with anomalies during childbirth, premature birth, interruption of pregnancy and even problems with the very possibility of becoming pregnant. Therefore, this method is not used in the treatment of cervical erosion in nulliparous patients.
Recommendations after cauterization of cervical erosion
General recommendations after cauterization of cervical erosion include:
- abstention from sexual contacts (at least within a month);
- ban on 1-1.5 months of physical activity, including dancing and any outdoor sports;
- contra-indication for bathing in any water bodies, including taking baths (only non-hot showers).
What else can not be done after cauterization of cervical erosion? Do not use vaginal tampons: use only sanitary napkins.
As an anti-inflammatory and antiviral agent (against genital herpes, cytomegalovirus and HPV), doctors recommend the local Epigen spray, which also removes itching and promotes mucosal regeneration.
If a patient has bacterial vaginosis, chlamydia or mycoplasmosis, antibiotics will be required. This is a vaginal pellet of Polizinax (with polymyxin and neomycin sulfate). This drug is prescribed for vaginal candidiasis, as well as in the composition there is nystatin.
Also, with the development of inflammation, Terzhinan is used - a combination antibacterial and antifungal agent in the form of vaginal tablets. Their gynecologists can recommend before conducting diathermocoagulation (one tablet intravaginally before bedtime) - to reduce the risk of inflammation.